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Amrita Basic Hand Surgery Course 2018

The Amrita Basic Hand Surgery course was held on 4th and 5th August 2018 under the aegis of Indian Society for Surgery of the Hand at Amrita Hospital, Kochi. The meeting was organised by the Department of Orthopaedics and Plastic Surgery of Amrita Hospital and focussed on training orthopaedic and plastic surgeons from all over Kerala and adjacent states.

In addition to the featured curriculum of topic presentations and hands-on video demonstrations, the CME also sponsored a worthy cause. In an effort to be environmentally mindful, all delegates received reusable jute bags and pens embedded with seeds. These special pens can be planted once they’ve run out, furthering the green initiative.

Diabetes contributing to rising incidence of heart failure

Kerala has a much younger demographic profile of people suffering from heart failure compared to Western nations

Coronary artery diseases are the most common cause of heart failure, accounting for 71% of cases

Female patients are more prone to death due to heart failure compared to men

Though no precise data on the incidence of heart failure exists in Kerala, statistics from the Trivandrum Heart Failure Registry show that the state has a much younger demographic profile – at least 12 years younger – suffering from heart failure compared to Western nations like the US. Coronary artery diseases are the most common cause of heart failure, accounting for 71% of all cases. This was stated by doctors at the Amrita Institute of Medical Sciences in the run up to the Amrita Heart Failure Update 2018, a one-day meet of cardiologists from India and abroad on the management of heart failure.

Heart failure happens due to the inability of the heart to pump blood as per the requirement of the body. It has several symptoms such as breathlessness, swelling of the ankles and fatigue. Diseases of the heart muscles, heart valves or heart covering are prominent causes. India has among the highest heart failure rates in the world.

Said Dr. K. U. Natarajan, Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences, Kochi: “The estimated incidence of heart failure in India is about 1% of the adult population, which translates to at least 8 to 10 million patients across the country. Old age is associated with higher incidence of heart failure. While the incidence in people above the age of 65 is 1 in 100 people, for those above the age of 75, it is 7 in 100 people. Diabetes is the most common risk factor for developing heart failure in Kerala, and its rapidly increasing incidence is causing a spike in the incidence of heart failure too.”

Talking about the risk factors, Dr. Vijayakumar M., Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences, said: “A variety of health conditions can heighten the risk of heart failure including hypertension and kidney diseases as well as smoking. We are also seeing large number of diabetic patients with heart failure, which shows that diabetes is also a prominent risk factor for the people of Kerala. In addition, there are large number of young people with coronary artery diseases (blockages in arteries supplying blood to heart muscles) who go on to develop heart failure. The most important thing in preventing heart failure is to identify the risk factors and try to halt the progression of these health conditions.”

Added Dr. Rajiv C., Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences: “Female patients are more prone to death due to heart failure, and the mortality rate is about 9 percent for them during hospitalization. However, in a study, an additional 9.6 percent of female patients died during a 90-day follow-up period after hospitalization, making the cumulative mortality rate at 18.6 percent. At the end of one year after hospitalization for heart failure, the mortality rate for female patients was a whopping 31 percent. Compared to developed countries, the duration of hospitalization for heart failure patients is also longer in India.”

Talking about the latest treatment options for heart failure, Dr. Rajesh Thachathodiyl, Professor, Dept. of Cardiology, Amrita Institute of Medical Sciences, said that medical science has been progressing rapidly and heart failure can now be treated with many types of surgeries, including a heart transplant. He said: “Implantable devices like automated implantable cardioverter-defibrillator (AICD) which detects and corrects abnormal beating of the heart, and Cardiac Resynchronization Therapy (CRT) which helps coordinate the contraction of heart muscles, are used for patients of heart failure. Several artificial hearts are also in development across the world, such as by Carmat, a French company. SensiVest is another device which heart failure patients can wear over their clothes. It monitors fluid buildup in the lungs (a common problem among patients of heart failure) and gives doctors advance warning of the impending trouble. A soft robotic sleeve which fits around the heart and compresses it in sync with its natural rhythm is another innovation taking place.”

The doctors were unanimous that to reduce the incidence of heart failure, the government needs to intensify the campaign to detect and treat health conditions such as hypertension, diabetes and obesity and discourage people from smoking. They said that it should also provide proper infrastructure, manpower and financial support to treat acute heart attacks effectively to prevent damage to the heart muscle.

Amrita surgeons remove football-size tumor from tribal boy's jaw

The 19-year-old patient from Jharkhand, leading an isolated life for the last ten years, underwent 14-hour surgery at Amrita Institute of Medical Sciences, Kochi

Surgeons reconstructed his upper jaw using his leg bone

This is the largest ever reported upper jaw tumor of its kind

The hospital performed the surgery free of cost

A 19-year-old tribal boy Amar Samad, son of a farmer in Jharkhand, was the butt of ridicule and living a secluded life since the last 10 years. The reason: he got afflicted with a rare genetic abnormality that resulted in a jaw tumor so large, it has not been reported in medical literature before. Thankfully, his life changed for the better a few days ago when a team of 12 surgeons at Kochi’s Amrita Institute of Medical Sciences (Amrita Hospital) removed the external deformity in a surgery lasting 14 hours. The hospital conducted the surgery free of cost considering the poor socio-economic background of the patient.

A football-size mass of matter, weighing 4.8 kg and measuring 20 x 20 x 20 cm, started growing on Amar’s upper jaw in 2008 and protruded out to the left. The dense collection of bone and fibrous tissue was diagnosed as “ossifying fibroma” on initial biopsy examination. This led not only to a grotesque appearance, but also difficulty in swallowing and speaking, in addition to social stigma that left the patient home-bound. He also suffered from a parathyroid adenoma (a benign tumor of the parathyroid gland) which might have initiated the problem.

Said Dr. Subramania Iyer, Head, Plastic & Reconstructive Surgery, Amrita Institute of Medical Sciences (Amrita Hospital): “Amar’s medical condition belonged to a very rare disease group called Hyper-parathyroidism Jaw Tumor Syndrome, which arises due to a genetic abnormality and causes small-size tumors on the jaw. His case is unique as a tumor of this size associated with this disease has not yet been reported in medical literature. In fact, this is the largest ever reported upper jaw tumor of its kind. The humongous growth was leading towards grave complications. If the condition had persisted, Amar would have found it impossible to eat, and breathing would have become a struggle. The calcium levels in his body had risen very high due to the disease.”

The removal of the tumor as well as reconstruction of the upper jaw was a great challenge. Added Dr. Subramania Iyer: “The tumor’s removal was complicated by its huge size and the involvement of the entire upper jaw and the left eye. The amount of blood loss was a cause of worry, but this was controlled by temporarily blocking blood vessels to the upper part of the face. Reconstruction had to be meticulously planned. We used 3D printing to construct an accurate model of Amar’s face and tumor, and conducted mock surgery for practice. Micro-surgical transfer of his leg bone was carried out to construct a new upper jaw. We had initially planned to remove his left eye, but managed to save it through meticulous surgery. His nose was reconstructed with bone, with plastic tubes acting as airways.”

The patient also underwent surgical removal of the parathyroid adenoma. After the surgical procedures, Amar’s parathyroid hormone and calcium levels have returned to normal. He now needs implants placed in his reconstructed upper jaw to act as teeth. The position of his left eye has to be readjusted to make it more acceptable cosmetically, though it has limited vision left. Both the eye and dental procedures will be conducted after six months.

Amar has two younger brothers in the family. His father passed away due to malaria in his childhood, and his mother left soon thereafter, leaving the children to be raised by their uncle. Amar used to work in the fields, but since his medical condition developed, he rarely ventured out of home and led an isolated life.

Amar’s case came to the notice of Dr. Sreehari Jingla from Jharkhand. Moved by his plight, and with the help of a visiting US doctor who knew about the head-and-neck reconstructive service available at the Amrita Hospital, he facilitated Amar’s treatment after being turned away from many reputed hospitals as the doctors were not confident they could handle the case.

After the successfully surgery, patient Amar Samad said: “Because of this huge deformity on my face, I could never mingle with other children of my age, as they used to be repulsed by my appearance. It is a huge relief to get the tumor off my face – it is almost like a second birth. I am now eager to go back home, make friends again and work in the fields. I thank the doctors of Amrita Hospital from the bottom of my heart for enabling me to lead a normal life.”

Amrita Hospital Received Kerala State Pollution Control Board’s Excellence Award

Amrita Hospital, Kochi, received Kerala State Pollution Control Board’s Excellence Award {Excellence among Medical Colleges (Govt & Autonomous)} for its sustained efforts to control pollution and environmental protection. Amrita Hospital has been conferred this award for the fourth consecutive year. The award carries trophy, certificate and prize money of Rs. 1,00,000/- (Rupees one lakh only)

Chief Minister, Sri. Pinarayi Vijayan presented the award in the function held at Thiruvananthapuram on June 07, 2018. The award was received by Dr. Jaggu, Additional General Manager; Sri. Rajappan, Head of Water Treatment and Biomedical Waste Management Department and Sri. R. R. Rajesh, Senior Research Officer of Amrita Institute of Medical Sciences.

The award has been instituted by the state government in different categories of organizations for best practices in pollution control, effective management to control air and water pollution, energy and water conservation and protection of environment. The award is given by the Kerala State Government to coincide with World Environment Day.

World No Tobacco Day Observed at Amrita Hospital

World No Tobacco Day 2018 was celebrated by the Amrita Institute of Medical Sciences Healthcare Campus with a number of programs. A commitment was made towards “Tobacco Free Kochi” by ATMA (Anti Tobacco movement At Amrita) and the student organisations of the campus like AYUDH. The MBBS, BDS, Nursing and other college students organised various awareness and cultural programs. A walkathon was conducted as part of the World No Tobacco Day. All the students of Amrita Institute of Medical Sciences, doctors and social workers participated in the walkathon. The anti tobacco movement program was inaugurated by Sri. Venugopal G. Kurup, SP, NCB, Kerala . Anti smoking pledge was taken by Dr. Col. Vishal Marwaha, Principal, Amrita School of Medicine; Dr. Vijayakumar, Professor, Department of Cardiology and Dr. Akhilesh K., Associate Professor, Pulmonary Medicine. Pranav Nair and Azhna Nizar, MBBS students spoke on the occasion.

There were also other programs conducted in Kochi. As part of World No Tobacco Day, Department of Pulmonary Medicine, Amrita Institute of Medical Sciences, Kochi and Amrita Urban Health Center, Kaloor along with Thevara Police Station conducted several programs in Kochi. Circle Inspector Sibi Tom inaugurated the function in Thevara Police Station premises. Dr. Akhilesh K., Associate Professor, Pulmonary Medicine; Sri Thankachan; Ratheesh, Health Inspector addressed the gathering. An anti-smoking pledge was administered by Dr. Akhilesh. Free pulmonary function test, leaflets, and antitobacco badges were distributed.